Mapping identity and connection : how first-time mothers make sense of premature birth

Abstract

First time motherhood in the context of premature birth is a specific experience of motherhood that has been relatively unexplored in the literature. This research examined the phenomena of meaning-making, identity formation, and relationship creation by first time mothers following “low risk” premature births.

Low risk premature births are moderate and late preterm births associated with a lack of serious, persistent medical concern alongside well understood and effective medical responses. The vast majority of premature births in New Zealand occur in this category and, as with elsewhere in the world, such births are on the rise. While understudied, this subset of premature infants carry significantly more risk factors than their full term peers.

Women who become mothers for the first time via the experience of premature birth must negotiate associated stresses, separations, and medical uncertainties in order to come to understand their lived experiences and evolve their identities as mothers. As with their low risk infants, exploration of the processes and perceptions of this group of mothers is underinvestigated.

The research employed the qualitative methodology of interpretative phenomenological analysis (IPA) to analyse semi-structured interviews with 15 participant mothers. Findings were generated in response to research questions that focussed on how participants made meaning of the event of premature birth, the relationship with their infants, and their nascent identities as mothers. Three unifying superordinate themes emerged and centred upon the mothers’ unique perspectives of their maternal experience (“Little things are big things”), the maternal distress associated with premature birth (“Maternal experience”), the particular obstacles mothers faced, and the avenues they pursued in an attempt to create a sense of themselves as mothers (“How do I become a mother?”).

Findings demonstrated that the identification of mothers and babies as low risk, created a paradoxical situation in which the perception that the babies were healthy and the mothers where healthy and competent actually increased the overall risk for the dyad. Furthermore, the findings suggested that mothers made meaning from within an ecological framework that was dyadic in nature. When mothers were considered outside of this dyadic maternal context—or when their infants were—surplus suffering occurred.

Findings have important implications for approaches to psychosocial interventions in neonatal intensive care units (NICUs), including psychological support and social work practice. When professionals are better able to see mothers’ needs where they have been previously concealed, mothers and their infants can be better served. Similarly, when professionals can understand, embrace, and respond to mothers from an awareness of dyadic ecology—what this thesis terms the “dyad-in-context”—approaches to support, advocacy, and treatment can move beyond compartmentalised medicalised approaches to more relational, responsive, authentic ways of being with mothers and their infants.